NPIMap

Organization Active NPI

Tree of Life Spine

  • Chiropractor
  • Allen, TX
National Provider Identifier
1073728424
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9922 Issued in TX
Legal business name
TREE OF LIFE SPINE
Practice address
309 S Jupiter Rd Ste 100
Allen, TX 75002-3052
Phone
(214) 547-7236
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ken Wilson
Title
DC
Phone
(214) 547-7234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 9922 TX Primary

Addresses

Primary practice location

309 S Jupiter Rd Ste 100
Allen, TX 75002-3052

Mailing address

309 S Jupiter Rd Ste 100
Allen, TX 75002-3052

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1073728424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S JUPITER RD STE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750023052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S JUPITER RD STE 100",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750023052",
            "telephone_number": "214-547-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREE OF LIFE SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "DC",
        "authorized_official_telephone_number": "214-547-7234",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.